Socio-demographic risk factors of ventilator-associated pneumonia in neonates:A Meta-analysis

Abstract

Objective To provide the evidences for the early-warning strategies of ventilator-associated pneumonia (VAP) in neonates,we systematically reviewed all related studies and analyzed the socio-demographic risk factors of VAP in neonates.Methods We retrieved all related studies in CNKI,Wanfang,VIP,CBM,Pubmed and Embase and evaluated their risk of bias by Newcastle-Ottawa Scale and analyzed all data by Meta-analysis.Results There were 21 case-control studies involving 3 546 neonates and 1 201 VAP patients and 6 socio-demographic risk factors of VAP in neonates being included.The odds ratio of deaths had significant differences between VAP and non VAP group (OR=2.98).Five studies involving 1 031 neonates were included,the average hospitalization days was significantly different between VAP and non-VAP group (MD=9.33).The average gestational age was significandy different between VAP and non-VAP group (MD =-3.05) and the odds ratio of VAP was significantly different between ≤ 37 w group and ＞37 w group (OR=2.62),between 32～37 w group and ＞37 w group (OR=2.37) and between ＜32 w group and 32～37 w group (OR=2.72).Nineteen studies involving 3 238 neonates were included,the average weight was significantly different between VAP and non-VAP group (MD=-0.58) and the odds ratio of VAP was significantly different between＜2.5 kg and ≥2.5 kg group(OR=3.75),between 1.5～2.5 kg and ＞2.5 kg group (OR=2.42) and between ＜1.5 kg and 1.5～2.5 kg group (OR=3.02).Conclusions In neonates,VAP is an important cause of death which prolongs hospitalization and increases economic burden.Our study confirms that the gestational age (≤37 w) and weight(＜2.5 kg) increase the risk of VAP and all neonates with lower weight and smaller gestational age have higher risk of VAP.Therefore,the weight and gestational age are important risk and early-warning factors. Key words: Neonates; Ventilator-associated pneumonia; Socio-demographic risk factors; Meta-analysis